| Stacs | |
|
3125 W Main St Kalamazoo MI 49006-2997 | |
| (269) 978-8874 | |
| (888) 712-9370 |
| Full Name | Stacs |
|---|---|
| Speciality | Clinic/Center |
| Location | 3125 W Main St, Kalamazoo, Michigan |
| Authorized Official Name and Position | Alan Strong (PRESIDENT) |
| Authorized Official Contact | 2699788874 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacs 3125 W Main St Kalamazoo MI 49006-2997 Ph: (269) 903-6638 | Stacs 3125 W Main St Kalamazoo MI 49006-2997 Ph: (269) 978-8874 |
| NPI Number | 1831562115 |
|---|---|
| Provider Enumeration Date | 11/09/2015 |
| Last Update Date | 06/29/2021 |
| Certification Date | 06/29/2021 |
| Medicare PECOS PAC ID | 5294142782 |
|---|---|
| Medicare Enrollment ID | O20210330000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831562115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Darline A Haley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346565892 PECOS PAC ID: 0042570897 Enrollment ID: I20180216000426 |
| Provider Name | Colleen E Cachero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144688508 PECOS PAC ID: 1254694342 Enrollment ID: I20180425000411 |
| Provider Name | Alan Strong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003243536 PECOS PAC ID: 6103233697 Enrollment ID: I20210330000582 |
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